Objective To explore the effects of percutaneous renal biopsy(PRB) on the etiological diagnosis and therapeutic regimen of patients with acute renal failure(ARF),so as to further improve the diagnostic and therapeutic levels of ARF.Methods From Nov.1992 to Dec.2007,176 patients were admitted in the Renal Division of Nanfang Hospital.All the patients matched the diagnostic criteria and were clinically diagnosed as ARF:within 48h the serum creatinine(SCr) ascended(≥26.5?mol/L) and increased by more than 50%,and the urine volume of less than 0.5ml/kg?h persisted in 6 hours.All the patients were undergone PRB and the clinical data were analyzed retrospectively.Results The final etiological diagnosis rate elevated from 64.2%(113/176) before PRB to 96.6%(170/176) after PRB.The coincidence of etiological diagnosis before and after PRB was 95.6%(108/113).Of 176 cases,170 were finally diagnosed as ARF,and the 6 remainders who were clinically misdiagnosed as ARF were finally diagnosed as chronic renal insufficiency(CRI).The therapeutic regimen for 83 patients was supplemented and for another 10 patients was modified after PRB,the total adjusted rate was up to 52.8%(93/176).After PRB,8 patients were finally diagnosed as IgA nephropathy,of them one case was specifically diagnosed as IgA protractedly leading to CRI,6 cases were ARF complicated with IgA,and one case was crescent formation induced by IgA nephropathy that leading to ARF.Conclusion PRB is a very useful technique for the etiological diagnosis of ARF on determining the therapeutic regimen and defining the prognosis.

During 2004 to 2009, 701 patients with diabetes were under community-hospital-based integrated management at Zhonghua and Xiagang community health-care service centers, Xiamen, Fujian.Changes of clinical indicators, life-style and frequency of checks for its complications in them were compared before and after the management. All clinical indicators decreased with length of management, with fasting blood glucose from ( 7. 6 ± 2. 3 ) mmol/L before management to ( 7. 3 ± 2. 0) mmol/L half a year after management, (7. 2 ± 2. 1 ) mmol/L one year after management, (6. 9 ± 1.7 ) mmol/L two years after management. Their life-style also improved significantly and frequency of checks for complications increased with: 54. 4% for retinopathy, 52. 5% for diabetic foot, and 51.8% for neuropathy after management (P ＜0. 05).

Objective To study the correlation between homocysteine levels and MTHFR C677T gene polymorphism of cerebral infarction.Methods Four hundred and fifty patients with cerebral infarction in our hospital were selected as the study group from February 2012 to August 2015,including 181 diabetes patients and 269 non-diabetic patients.Also 285 cases of physical examination healthy people in the outpatient department were selected as the control group.The MTHFR C677T polymorphism and the correlation between genotype and Hcy levels were analyzed by pyrosequencing.Results The difference of distributions of MTHFR genotype between the study group and the control group was statistically significant (P ＜ 0.05).The frequency of the T gene in the study group was significantly higher than the control group,the difference was statistically significant (x2 =13.67,P =0.00).The Hcy concentrations of the study group was significantly higher than the control group,and the difference was statistically significant (t =12.71,P =0.00).The Hcy levels of different MTHFR genotype in the cerebral infarction patients were statistically significant (F =17.68,P =0.00).Hcy levels in non-diabetic patients with cerebral infarction was significantly higher than in diabetic patients with cerebral infarction,and the difference was statistically significant (t =2.97,P =0.00).Hcy concentrations of TT genotype of non-diabetic group was significantly higher than the TT genotype of the diabetic group,CC type Hcy concentration significantly lower than the diabetic group,and the differences were statistically significant (t =5.67,2.18;P =0.00,0.03).In cerebral infarction patients both with non-diabetic and diabetic,the Hcy levels of MTHFR gene TT genotype were significantly higher than those of CC and CT genotype,and the differences were statistically significant (P ＜ 0.05),and the differences of Hcy levels between the genotype of CT and CC was not statistically significant (P ＞ 0.05).Conclusion The T allele frequency of MTHFR C677T in the cerebral infarction patients is much higher than healthy people.MTHFR TT genotype is related to serum Hcy levels.Maybe it is a risk factor for cerebral infarction.

Objective To investigate the role of tumor suppressor gene PTEN in colorectal cancer. Methods Using Northern blot,immunohistochemistry, colorectal carcinoma was examined in 47 cases. ResultsKG1 The expression of PTEN mRNA in colorectal cancer was lower than that in paired para-carcinoma tissues( P

Objective To explore the pathologic factors influencing the long-term survival of patients with relapsing and/or metastatic colorectal cancer (CRC) after radical operation for founding a basis for the clinical treatment protocols.MethodsThe clinical data were collected of 132 patients who were with relapsing and/or metastatic colorectal cancer (CRC) after radical resection,hospitalized from the beginning of 2002 to the end of 2007,and had integrated hospitalization and follow-up data.The relationship between the clinic pathologic factors and long-term survival was retrospectively analyzed.ResultsUnivariate analysis showed that the survival rate was higher in the patients with single recurrence and/or metastasis than in those with multiple recurrences and/or metastases,in the patients with relapsing and/or metastatic rectal cancer than in those with relapsing and/or metastatic colon cancer,and in patients received secondary operation than in those received non-operative treatment.Cox multivariable regression model analysis showed that the treatment modality for recurrence and/or metastasis,the number of recurrence and/or metastasis sites,the invasive depth of primary tumor,and lymph node metastasis were correlated with the long-term survival of patients.Among them,the treatment modality was the most important factor influencing the prognosis.ConclusionsThe recurrence and/or metastasis rate is higher in the patients with rectal cancer than in those with colon cancer,but the prognosis of the former is better than that of the latter.Secondary operation,which is helpful for the long-term survival,is suggested for the patients with relapsing and/or metastatic CRC.

Objective To explore the serum proteomics characteristics of early carcerization of post-hepatitic cirrhosis.MethodsThe serum protein profiles were detected of 62 patients with post-hepatitic cirrhosis and 100 patients with hepatic carcinoma in Ⅰ-Ⅱ stage (T1-2N0M0) and cirrhosis by surface-enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS) IMAC30-Cu2+ ProteinChip array (Ciphergen Biosystems Inc.,USA),the distinct proteins were analyzed and a classification tree model was established by using Biomarker Patterns software.The diagnostic efficacy of the model was blindly tested using the serum protein from both groups.ResultsThe serum protein profiles of post-hepatitic cirrhosis and hepatic carcinoma complicating with cirrhosis were analyzed and a classification tree model was established including 4 distinct proteins with different M/Z.In the training mode,the accuracy was 99.4% (161/162) on differential diagnosis to differentiate post-hepatitic cirrhosis and hepatic carcinoma complicating with cirrhosis,the sensitivity and specificity were 99.0% (99/100) and 100.0% (62/62),respectively,on the diagnosis of hepatic carcinoma complicating with cirrhosis.In the testing mode,the accuracy of differential diagnosis was 94.4% (153/162),the sensitivity and specificity were 95.0% (95/100) and 93.5% (58/62) on the diagnosis of hepatic carcinoma complicating with cirrhosis.ConclusionSELDI-TOF-MS ProteinChip technique is of convenient and rapid,and with high sensitivity and specificity on the diagnosis of early carcerization of post-hepatitic cirrhosis.

Objective To study the reconstructive treatment of the different types of neurofibroma and neurofibromatosis in different locations. Methods 37 patients with neurobibroma or neurofibromatosis were reviewed, including 8 cases with simple suture after excision, 9 cases with skin grafting in situ, 12 cases with skin flap grafting. The main points of the treating methods for different types of neurofibroma and neurofibromatosis were discussed, and the chief clinical manifestations, therapeutic principle and notices of the operation were then summarized.Results These 37 patients, including 25 cases of neurofibroma, 11 cases of neurofibromatosis typeⅠ and 1 case of neurofibromatosis type Ⅱ, were satisfied with the results after reconstructive operation. Conclusion The methods of reconstructive operation of neurofibroma and neurofibromatosis, such as simple suture after excision, skin grafting in situ, skin flap grafting, the use of skin soft tissue expansion, microskin grafting and so on, must be selected according to the different type and location of the neurofibroma and neurofibromatosis. The reconstructive operation must guarantee the best recovery of the visage and the function on the basis of the most degree of tumor excision.

Objective To study the psychological health state of parents of children patients with hand foot mouth disease and provide scientific basement for clinical nursing care. Methods Zung self- rating anxi-ety scale (SAS) and self-designed investigation scale were used to survey 98 parents of children patients with hand foot mouth disease,and selective nursing intervention was adopted. Results The anxiety scores of the parents were significantly higher than those of the normal mode, and their psychological symptom was influ-eneed by various factors. After the nursing intervention, the anxiety degree was significant different from that of before intervention. Conclusions Psychological health levels of the parents of children with hand foot mouth disease were markedly lower than those of healthy individuals. Psychological nursing care should not only in-clude children but also their parents in order to alleviate their bad mental state.

Objective To observe the effect of power-assisted functional electrical stimulation (PAFES)therapy on ankle joint function recovery in stroke patients.Methods Ninety hemiplegic stroke patients were randomly and evenly divided into a control group,a PAFES group,and a neuromuscular electrical stimulation (NMES)group.All groups received conventional rehabilitation training.PAFES group adopted PAFES treatment on affected lower extremities and NMES group was given the NMES therapy on the tibialis anterior of the affected lower limbs,in addition to conventional rehabilitation training.The active range of motion (AROM) of ankle dorsiflexion,FuglMeyer motor assessment (FMA),Barthel index (BI) and Ankle flexion and extension movement (AFEM) in 10 seconds were evaluated before the trial and after 4 weeks treatment.Results After treatment,there were significant differences in the AROM of ankle dorsiflexion,FMA,BI and AFEM (P ＜ 0.05) compared with before treatment within each group.The improvement of AROM of ankle dorsiflexion in PAFES group (8.19 ± 3.39) ° and the values in NMES group (8.96 ± 3.68) ° were to a significantly greater extend than control group (3.88 ± 4.10) ° (P ＜0.05) ; the improvement of FMA and BI in PAFES group was also superior to those in NMES group and control group (P ＜ 0.05).Conclusion The intelligent PAFES therapy could help improve AROM of ankle dorsiflexion,the motor function of the affected lower extremity and the ability of the activities of daily living in stroke patients.

Objective Recurrence of local segmental glomerulosclerosis (FSGS) in 2 patients with renal allograft was reported.Methods A male child aged 15 years and a male adult aged 25 years with primary FSGS, who were subjected to cadaveric kidney transplantation, had a recurrent nephritic syndrome showing massive proteinuria, hyperlipidemia and hypertension respectively in 2 weeks and 18 months postoperatively, that was suspected a recurrent FSGS. The child immediately was treated with Benazepril hydrochloride, 30?mg /day plus high dosage of Prednisolone ( 1?mg /kg every day) for 6 weeks, but proteinuria did not to be ameliorated. The adult was treated with high dosage of Prednisolone ( 1?mg /kg every) and Tripterygium wifordii for 12 weeks, but the syndrome was not improved. Results Two patients had recurrent FSGS according to renal biopsy revealing characterized by similar features: diffuse effacement of foot processes on electron microscope, segmental or focal sclerosis under light microscope and IgM, IgG, C3 deposits. The therapy of plasmapheresis as well as high dosage of Benazepril hydrochloride was added to institute respectively for continuous 3 sessions with removal of 1.5 volume plasma ( 1 200?ml of plasma) in the child and successive 6 sessions with removal of same volume ( 3 000?ml of plasma). The child's proteinuria had a significant reduction from 8.29?g /day to 4.52?g /day after a week post pheresis, that kept 4.52 ～ 5.56 ?g/day with stable creatitine (180～200??mol/L) following 18 months. The adult's proteinaria obvious decreased from 4.68?g /day to 1.50?g /day after plasma exchange a week and keeping decline to 1.06?g /day with normal renal function following 12 months. Conclusion FSGS may immediately be recurrence in pediatric renal transplants. The mechanism of recurrent FSGS may be associated with excessive glomerular filtration, circulating factor altering glomerular permeability, injection of anti thymocyte and lymphocyte immunoglobulin, and hyperlipidemia. Plasmapheresis in combined with ACE inhibitor can reduce proteinuria significantly rather than a single ACE inhibitor.